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-~ M ~ <br />_,,_ <br />• - TYPE OR PRINT CLEARLY <br />14. Present land use Agricultural <br />(i.e., agricultural, industrial, etc.) <br />15. Proposed future land use Agricultural <br />(Goal of reclamation) <br />This application form must be submitted in duplicate and each form must <br />be accompanied by the following information and items. The application <br />will not be processed until complete. See RULE 3 (for Limited Impact) <br />or RULE 4 (for Special 10-day) for additional guidance. <br />ERRIBIT A - Legal Description <br />The legal description moat identify the affected land and be wholly adequate for <br />field location of the property. It can be in the form of metes and bounds survey <br />or a description by reference to township, range, and section to at least the <br />nearest quarter quarter section. Where applicable, the street address or lot <br />number(s) may be used. <br />E7~IBIT B - Mining Plan <br />This can be a general discussion of the methods, equipment, phases or stages of <br />the operation and those portions of land affected by each. The plan should be <br />closely correlated with the map and should show where extraction will begin, which <br />direction it will proceed. <br />EBBIBIT C - Map <br />This map should be as comprehensive as possible is terms of clearly defining <br />eha permit boundaries and indicating all roads or stockpile areas to be used in <br />connection with the operation. All immediately adjacent landowners must be shown. <br />The closest quarter section corner, section line, or any other locateable point <br />should also be shown on the map. <br />E1~IBIT D - Wildlife, Water Resources, Vegetation and Soils Information <br />Each of the above-mentioned subjects moat be addressed as outlined in the <br />applicable Rule, under item number ten (10). <br />ESSIBIT E - Reclamation Plan <br />As with the mining plan, this should be a general discussion of the methods, <br />equipment, phases or stages of the reclamation process and those portions of <br />land affected by each. If possible, the plan should be closely correlated <br />with the map. If nod, the narrative must be comprehensive enough to draw an <br />accurate verbal picture of the expected physical appearance of the area after <br />completion of reclamation. <br />E70iIBIT F - Pzoof of Local Government Approval <br />This must be a letter from the local government specifying coafosmance with <br />existing zoning regulations. <br />E]OiIBIT G - Source of Legal Right to Enter <br />This could be a copy of the lease, deed, abstract of title, or current tax <br />receipt. Ia lieu thereof, a statement acknowledged by a notary public that <br />the operator has the legal right to eater sad mine will be accepted. <br />**FOR SPECIAL 10-DAY PERMITS ONLY** <br />ERHIBIT B - Reclamation Costs <br />If the surety is requested to be less than $2500, the operator must submit <br />facts to support such request. Otherwise a surety of $2500 will automatically <br />be set. <br />ERIiIBIT I - Terms of Governmental Contract <br />The operator must submit a copy of the contract or other proof that proves the <br />necessity of a special 10-day permit. The operator must also submit evidence <br />of the surety provided under the governmental contract, if it was required. <br />~a~~ <br />